The Impact of Web-Based Cognitive-Behavioral Therapy on Chronic Pain Acceptance in Patients with Rheumatoid Arthritis

Authors

    Rahil Omidvar PhD student of health psychology, Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran
    Mahdi Nayyeri * Assistant Professor,PhD of health psychology, Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran mahdi.nayyeri@iau.ac.ir
    Saeed Teimoori Associate Professor, PhD in psychology of exceptional children Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran
https://doi.org/10.61838/kman.hn.2.1.5

Keywords:

Cognitive-behavioral therapy, Web-based, Chronic pain acceptance, Rheumatoid arthritis

Abstract

The aim of this study was to determine the impact of web-based cognitive-behavioral therapy on chronic pain in patients with rheumatoid arthritis. The present study was an applied-semi-experimental research with a test and control group, utilizing a pretest-posttest design. All adults aged 30 to 60 years suffering from rheumatoid arthritis and visiting the clinics of two rheumatology subspecialists in the city of Mashhad constituted the research population. Considering the possibility of attrition, 21 individuals were allocated to the intervention group and 15 to the control group. After the research sample was determined in both the test and control groups, questionnaires on personal characteristics and chronic pain acceptance were completed by them, followed by the implementation of a cognitive-behavioral therapy training program for the intervention group in 8 sessions of 60 minutes each, web-based and through Skyroom. The control group did not receive any specific training. After the intervention ended, the questionnaires were completed again. Two months after the intervention, the questionnaires were filled out again by the groups for follow-up and to assess the persistence of the effect. Data were analyzed using SPSS V26 and EXCEL V2019 software. Based on the findings, web-based cognitive-behavioral therapy affects the acceptance of chronic pain in patients with rheumatoid arthritis. Therefore, considering the results of this research and other studies on the effectiveness of cognitive-behavioral group therapy in chronic physical diseases, in addition to medical treatments, the use of online psychological interventions can be beneficial and productive in increasing the acceptance of chronic pain and improving various functional dimensions of these patients.

Downloads

Download data is not yet available.

References

1. Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD,

Tanasescu R. Extra-articular Manifestations in Rheumatoid

Arthritis. Maedica (Bucur). 2010;5(4):286-91.

2. Conforti A, Di Cola I, Pavlych V, Ruscitti P,

Berardicurti O, Ursini F, et al. Beyond the joints, the extraarticular manifestations in rheumatoid arthritis. Autoimmunity

Reviews. 2021;20(2):102735. [PMID: 33346115] [DOI]

3. Smolen JS, Aletaha D, Barton A, Burmester GR, Emery

P, Firestein GS, et al. Rheumatoid arthritis. Nature Reviews

Disease Primers. 2018;4(1):18001. [PMID: 29417936] [DOI]

4. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M,

Abbasifard M, et al. Global burden of 369 diseases and injuries in

204 countries and territories: a systematic analysis for the Global

Burden of Disease Study 2019. The Lancet.

2020;396(10258):1204-22. [PMID: 33069326] [DOI]

5. Albrecht K, Zink A. Poor prognostic factors guiding

treatment decisions in rheumatoid arthritis patients: a review of

data from randomized clinical trials and cohort studies. Arthritis

Research & Therapy. 2017;19(1):68. [PMID: 28335797]

[PMCID: PMC5364634] [DOI]

6. Sturgeon JA, Finan PH, Zautra AJ. Affective

disturbance in rheumatoid arthritis: psychological and diseaserelated pathways. Nature Reviews Rheumatology.

2016;12(9):532-42. [PMID: 27411910] [PMCID: PMC5449457]

[DOI]

7. Matcham F, Ali S, Hotopf M, Chalder T. Psychological

correlates of fatigue in rheumatoid arthritis: A systematic review.

Clinical Psychology Review. 2015;39:16-29. [PMID: 25912978]

[DOI]

8. Taylor P, Manger B, Alvaro-Gracia J, Johnstone R,

Gomez-Reino J, Eberhardt E, et al. Patient Perceptions concerning

Pain Management in the Treatment of Rheumatoid Arthritis.

Journal of International Medical Research. 2010;38(4):1213-24.

[PMID: 20925993] [DOI]

9. Studenic P, Radner H, Smolen JS, Aletaha D.

Discrepancies between patients and physicians in their

perceptions of rheumatoid arthritis disease activity. Arthritis &

Rheumatism. 2012;64(9):2814-23. [PMID: 22810704] [DOI]

10. Koop SM, ten Klooster PM, Vonkeman HE,

Steunebrink LM, van de Laar MA. Neuropathic-like pain features

and cross-sectional associations in rheumatoid arthritis. Arthritis

research & therapy. 2015;17(1):1-8. [PMID: 26335941] [PMCID:

PMC4558794] [DOI]

11. Firoozi M, Besharat MA, Souri Z. The predicting effect

of attachment styles on pain catastrophizing, self-efficacy and

acceptance in patients with chronic pain. Anesthesiology and

Pain. 2018;9(1):55-67.

12. Aghayousefi A, Tarkhan M, Mohammadi N, Afshar H.

The Role of Psychological Inflexibility and Pain Acceptance in

Predicting of Resiliency in Chronic Pain Patients. Health

Psychology. 2017;5(17):23-38.

13. Gol A, Aghamohamedian Shearbaf H, Begdoli I, Farid

Hosseini F. Investigating the Predictive Role of Contextual

Factors, Psychological Flexibility, Acceptance and Selfcompassion, in Quality of Life of Migraine Patients. Journal of

Nursing Education. 2023;11(2):74-86.

14. Laird KT, Tanner-Smith EE, Russell AC, Hollon SD,

Walker LS. Comparative efficacy of psychological therapies for

improving mental health and daily functioning in irritable bowel

syndrome: A systematic review and meta-analysis. Clinical

Psychology Review. 2017;51:142-52. [PMID: 27870997] [DOI]

15. Goldin PR, Ziv M, Jazaieri H, Werner K, Kraemer H,

Heimberg RG, Gross JJ. Cognitive reappraisal self-efficacy

mediates the effects of individual cognitive-behavioral therapy for

social anxiety disorder. Journal of Consulting and Clinical

Psychology. 2012;80(6):1034-40. [PMID: 22582765] [PMCID:

PMC3424305] [DOI]

16. Windgassen S, Moss-Morris R, Chilcot J, Sibelli A,

Goldsmith K, Chalder T. The journey between brain and gut: A

systematic review of psychological mechanisms of treatment

effect in irritable bowel syndrome. British Journal of Health

Psychology. 2017;22(4):701-36. [PMID: 28573818] [DOI]

17. Everitt HA, Landau S, O’Reilly G, Sibelli A, Hughes S,

Windgassen S, et al. Assessing telephone-delivered cognitive–

behavioural therapy (CBT) and web-delivered CBT versus

treatment as usual in irritable bowel syndrome (ACTIB): a

multicentre randomised trial. Gut. 2019;68(9):1613-23. [PMID:

30971419] [PMCID: PMC6709776] [DOI]

18. Shaffer KM, Camacho F, Lord HR, Chow PI, Palermo

T, Law E, et al. Do treatment effects of a web-based cognitive

behavioral therapy for insomnia intervention differ for users with

and without pain interference? A secondary data analysis. Journal

of Behavioral Medicine. 2020;43(3):503-10. [PMID: 31152334]

[PMCID: PMC6885103] [DOI]

19. Milgrom J, Danaher BG, Seeley JR, Holt CJ, Holt C,

Ericksen J, et al. Internet and Face-to-face Cognitive Behavioral

Therapy for Postnatal Depression Compared With Treatment as

Usual: Randomized Controlled Trial of MumMoodBooster. J Med

Internet Res. 2021;23(12):e17185. [PMID: 34889742] [PMCID:

PMC8701704] [DOI]

20. Liu T, Geng Y, Han Z, Qin W, Zhou L, Ding Y, et al.

Self-reported sleep disturbance is significantly associated with

depression, anxiety, self-efficacy, and stigma in Chinese patients

with rheumatoid arthritis. Psychology, Health & Medicine.

2023;28(4):908-16. [PMID: 35156474] [DOI]

21. Robati Z. Effect of Cognitive-Behavioral Group

Therapy on Pain Self-efficacy, Fatigue, Life Expectancy and

Depression in Patients With Multiple Sclerosis: A Randomized

Controlled Clinical Trial. Psychiatry and Clinical Psychology of

Iran. 2021;26. [DOI]

22. Siengsukon CF, Beck ES, Jr., Drerup M. Feasibility and

Treatment Effect of a Web-Based Cognitive Behavioral Therapy

for Insomnia Program in Individuals with Multiple Sclerosis: A

Pilot Randomized Controlled Trial. International Journal of MS

Care. 2020;23(3):107-13. [PMID: 34177382] [PMCID:

PMC8218587] [DOI]

23. Yang J, Lo WLA, Zheng F, Cheng X, Yu Q, Wang C.

Evaluation of Cognitive Behavioral Therapy on Improving Pain,

Fear Avoidance, and Self-Efficacy in Patients with Chronic Low

Back Pain: A Systematic Review and Meta-Analysis. Pain

Research and Management. 2022;2022:4276175. [PMID:

35345623] [PMCID: PMC8957446] [DOI]

24. McCracken LM, Vowles KE, Eccleston C. Acceptance

of chronic pain: component analysis and a revised assessment

method. PAIN. 2004;107(1). [PMID: 14715402] [DOI]

25. Cascarilla EA. Chronic Pain-Related Distress;

Disability: An Empirical Investigation of a Modern Behavioral

Theory of Acceptance of Chronic Pain: University of Akron;

2009.

26. Arabkhradmand J. The Effect of Schema Therapy on

Pain Acceptance, Pain Self-Efficacy, Pain Intensity, Emotion

Regulation in Spinal Column Surgery Patients. J Anesth.

2021;11(4):19-29.

27. Keefe FJ, Caldwell DS, Williams DA, Gil KM, Mitchell

D, Robertson C, et al. Pain coping skills training in the

management of osteoarthritic knee pain-II: Follow-up results.

Behavior Therapy. 1990;21(4):435-47. [DOI]

28. Ghooshchian Choobmasjedi S, Moghimi J, Behnam B.

Role of pain and its associated cognitive related variables in the

patients with rheumatoid arthritis. Scientific Journal of Kurdistan

University of Medical Sciences. 2013;18(2):58-66.

29. Nazemi Ardakani F, Bahrami Ehsan H, Alipour A,

Bayat N. Effectiveness of cognitive behavioral stress management

intervention on psychological and immune factors in patients with

Rheumatoid Arthritis referred to the rheumatology clinics of

Baghiat Allah hospital. Journal of Military Psychology.

2015;6(22):55-65.

30. Vesal M, Taher Neshatdoost H. Meta-analysis of

psychological interventions effectiveness on reduction of pain

intensity among patients with chronic pain. JAP. 2019;10(3):21-

38.

31. Pourshahbazi M, Imani M, Sarafraz MR. Relationship

between Sprituality and Practice of Religious Beliefs with Pain

Acceptance in Rheumatoid Arthritis Patients. Journal title.

2018;11(4):43-54.

Downloads

Additional Files

Published

2024-01-01

How to Cite

Omidvar, R. ., Nayyeri, M., & Teimoori, S. . (2024). The Impact of Web-Based Cognitive-Behavioral Therapy on Chronic Pain Acceptance in Patients with Rheumatoid Arthritis. Health Nexus, 2(1), 35-42. https://doi.org/10.61838/kman.hn.2.1.5